Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Apr 2020
[Abdominal Sonography in Medical Emergencies: do Complete Abdominal Scans offer Advantages over a Focused Strategy?]
To determine, whether in case of abdominal emergencies, complete abdominal ultrasound scans offer advantages over a goal-directed strategy in regard to problem-solving and detection of relevant pathologies. ⋯ In medical abdominal emergencies, ultrasound scans of the complete abdomen detect more relevant pathologies and solve more problems than focused sonography does.
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Dtsch. Med. Wochenschr. · Apr 2020
Case Reports[Acute exacerbation of reactivated chronic hepatitis-b after stopping antiviral medication followed by loss of HBsAg].
A 66-year-old women with chronic hepatitis-b and antiviral therapy was presented with icterus and sickness 2 weeks after cold symptoms. The treatment was stopped by patient 6 month before. The liver was enlarged, the abdomen and further body status unsuspicious. ⋯ Acute exacerbation of chronic hepatitis-b followed stopping antiviral treatment can lead to healing by loss of HBsAg.
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A 33-year old Romanian chef presented with sudden onset of chest pain and chills as well as a significant elevation of myocardial markers and CRP. ⋯ Myocarditis is a rare manifestation of Q fever, which should not be missed. The diagnostic evaluation with antibody titers is easy. The antibiotic therapy is well tolerated and is a causal treatment that helps to prevent long-term damage.
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Dtsch. Med. Wochenschr. · Apr 2020
[Cardiovascular infections - recent progress and future challenges].
Patients with previous endocarditis are at highest risk of infective endocarditis (266-fold compared to the general population) - preventive strategies are of particular importance in this patient subgroup. Patients with community-acquired E. faecalis bacteremia should undergo transesophageal echocardiography - according to a recent study the prevalence of endocarditis may be ≥ 20 % in this setting. Several smaller observational studies suggest an association between E. faecalis endocarditis and colorectal neoplasias - colonoscopy should therefore be offered to patients with newly diagnosed E. faecalis endocarditis (particularly in patients with unknown portal of entry). ⋯ Approximately one out three patients with a left ventricular assist device (LVAD) will suffer from LVAD-related infections during the first year after implantation. Appropriate antibiotic treatment and adequate surgical debridement are essential management strategies.
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Dtsch. Med. Wochenschr. · Apr 2020
[Interstitial lung disease in rheumatic diseases - new therapeutic approaches].
Pulmonary involvement is an important aspect in the management of rheumatic diseases. Connective tissue disease-associated interstitial lung diseases (CTD-ILD) are of particular importance, as their occurrence is often decisive for patient outcome. We use corticosteroids, immunosuppressants and eventually also biologicals in the therapy of CTD-ILD. ⋯ Currently a number of other studies regarding the effectiveness of antifibrotics in CTD-ILD are expected to be published. The studies in this field bring new aspects in the understanding of interstitial diseases and have the potential of expanding treatment options in CTD-ILD. The topic of CTD-ILD is a difficult, but at the same time exciting field.